1. Field of the Invention
The present invention concerns in general the optimization of procedures in radiological diagnostics. The present invention more particularly concerns an intelligent and thus adaptive data acquisition or image processing in order to achieve an improvement with regard to interface design, training and documentation in radiological image-processing evaluation of medical findings.
2. Description of the Prior Art
Radiological exposures typically exist in digitized form. Examples are tomographic exposures (computed tomography (CT), magnetic resonance tomography (MRT) as well as sonographic exposures (ultrasound (US)) or videos obtained using a laparoscope.
Image workstations of high power and image quality are available to the radiologist for image interpretation and evaluation. The platform of such an image workstation conventionally forms a host computer with high-contrast monitors as a user interface as well as an image memory together with a standardized module library for image-processing programs (tools). The host computer is supported by fast image computers to increase the computation capacity.
Such image workstations are based on complicated hardware and software components that must already be coordinated with one another in the development process. For this purpose, a team of experts from the users and the manufacturer must create and implement a binding, predetermined project phase plan in order to be able to adapt the system to a largest-possible spectrum of task situations.
Such a task defines a workflow that is specified either by the treating physician (house physician, surgeon, etc.) or by the radiologist based on the purpose of the diagnosis. Such a workflow generally begins with the image generation of relevant organs or body parts, with one or more different imaging modalities (CT, MRT, US, laparoscopy, etc.). The images, image series or videos of the body parts and organs acquired by the respective modalities are suitably displayed on the radiological image workstation and respectively subjected to a predetermined or experience-dependent image evaluation process (procedure) until a suitable representation of the corresponding body regions allows a medical finding.
The workflow is ended with the respectively evaluated images being electronically stored with the findings, and possibly with finding data, and being transferred to the treating physician or archived.
A conventional procedure is schematically shown in the flowchart of FIG. 1, starting from a radiological image acquisition that has already occurred, whereby a differentiation is made between the interactive activity of the user by means of keyboard and mouse on the screen, and the algorithmic program process on the computer level that is thereby initiated:
For example, a digital (for example spiral, CT or MRT) overview exposure of the lungs is presented to the user. In order to be able to evaluate the lungs, according to the prior art the user has the possibility of selecting an already-existing procedure and to start its process (step S1). A tool palette 1 thereupon appears on the screen, as shown, for example, in FIG. 4. The tool palette 1 includes a series of buttons, each button symbolizing a specific tool and thus a specific image-processing program. Each tool can be invoked by clicking the corresponding button with the mouse. For example, in FIG. 4 the first button 2 represents an enlargement-shrinking function (zoom). The buttons on the tool palette are dependent on the output image and normally are arranged such that precisely the procedure-specific image processing steps are offered that (for the current output image) lead to a modified image that can be optimally evaluated. The steps are implemented by sequential clicking in the sequence of the arrangement and, if needed, with inputs via the keyboard.
Ultimately, the activity of the user on the screen effects an algorithmic processing by image processing software on the computer level (step S3, which ultimately leads to the evaluable image. The user stores the final image as well as the finding (typically generated in text format) (steps S4, S5) and ends the procedure (step S6).
The user is not forcibly bound to the provided processing steps (Tools) of the or, respectively, a selected procedure; rather, in the event that he deems it to be advantageous, he can invoke further or different tools via a program menu implemented by the manufacturer in order to modify or even generate completely new procedures. For example, in FIG. 4 it is possible for the user to invoke a different tool palette (Tools2) on which further tools are offered.
If a deviation of an image processing series occurs in a procedure, conventionally only the result image is stored with the corresponding finding on the computer level (step S5). The procedural process that ultimately leads to an optimal (because it was evaluable) image, however is not documented according to the prior art.
With presently-existing medical image workstations it is desired by radiologists to optimize (deviating from predetermined workflows and procedures) the image generation, image processing and evaluation in order to increase the patient throughput in radiology, or to make the system operation more efficient and to expand it.
Today's image workstations have no possibility (or a possibility that can be implemented only with a great deal of effort) to introduce optimizations into the system. Without drastic changes to the system software with corresponding changes to the operating instructions, a cost-effective and simple operation oriented to practice is not possible.
Previously an improved operation or a more efficient workflow would have to be recorded via monitoring by test persons (who work on the system under normal conditions) and subsequently integrated into the system in hardware and/or software. The operating manuals would have to be correspondingly amended and the customers specifically trained.
In order to avoid this circumstance, in newer software packages the user interface has been designed to allow it to be changed, dependent on the user, via freely-configurable buttons. Examples for this are generally typical user interfaces such as, for example, Microsoft Office®. This type of configuration is, however, only little known and is therefore mostly used only by advanced program users. It also assumes a relatively high proficiency on the part of the user.
In the framework of medical image workstations it has been shown that the customer expects solutions to the above-described situation from the manufacturer. The present technical implementation is to request support personnel via service centers in order to effect configuration changes (further tools, procedure configuration data, change of tool palettes) on site on the existing system. This ensues, for example, by means of configuration software (see DICOM, “Digital Imaging and Communications in Medicine”, Supplement 60, “Hanging Protocols”) and is last but not least time-intensive and cost-intensive due to the personnel involvement.